Medicaid provides health coverage and long-term care services and supports for low-income individuals and families, covering more than 76 million Americans and accounting for about 1 in 6 dollars spent on health care.1 Medicaid is a large source of spending in both state and federal budgets, making program integrity efforts important to prevent waste, fraud, and abuse and ensure appropriate use of taxpayer dollars. Recent audits and improper payment reports have brought program integrity issues back to the forefront. This brief explains what program integrity is, recent efforts at the Centers for Medicare and Medicaid Services (CMS) to address program integrity, and current and emerging issues.
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